NPI | 1962922781 |
---|---|
Former Name | BETHANY MARY UNDERWOOD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208M00000X Hospitalist (Licence: IL 036.152152) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036.152152) |
Enumeration Date | 2017-06-22 |
Last Update Date | 2021-11-29 |